Bacterial meningitis - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Bacterial meningitis represents a life-threatening inflammation of the meninges. Streptococcus pneumoniae and Neisseria meningitidis are the predominant causative pathogens in both adults and children.
It commonly affects extremes of age (<2 months and >60 years) because of impaired or waning immunity.
A lumbar puncture to obtain cerebrospinal fluid is the most important investigation when a diagnosis of bacterial meningitis is considered.
Empiric antimicrobial therapy should be started promptly. When the specific organism is identified, treatment can be modified accordingly.
Hearing should be tested before discharge or within 4 weeks after discharge in all children with bacterial meningitis to detect any hearing loss as early as possible. Long-term audiologic follow-up is only needed for patients with early onset hearing loss.

Ventral view of human brain showing purulent basilar meningitis infection due to Streptococcus pneumoniae

Image provided by the CDC Public Health Image Library

Quick Reference

History & Exam
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Diagnostics Tests
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Laboratory-confirmed cases of invasive meningococcal disease in England by capsular group and epidemiologic year. The light blue and dark blue arrows denote the start of the national immunization programme against group C meningococcal (MenC) disease and group B meningococcal (MenB) disease, respectively
Ventral view of human brain showing purulent basilar meningitis infection due to Streptococcus pneumoniae
Photomicrograph of Gram-stained Streptococcus species bacteria

Citations

Key Articles

van de Beek D, Cabellos C, Dzupova O, et al. ESCMID guideline: diagnosis and treatment of acute bacterial meningitis. Clin Microbiol Infect. 2016 May;22(suppl 3):S37-62.[Abstract][Full Text]
Tunkel AR, Hasbun R, Bhimraj A, et al. 2017 Infectious Diseases Society of America's clinical practice guidelines for healthcare-associated ventriculitis and meningitis. Clin Infect Dis. 2017 Mar;64(6):701-6.[Abstract][Full Text]
Brouwer MC, McIntyre P, Prasad K, et al. Corticosteroids for acute bacterial meningitis. Cochrane Database Syst Rev. 2015 Sep 12;(9):CD004405.[Abstract][Full Text]

Other Online Resources

CDC: recommended child and adolescent immunization schedule for ages 18 years or younger, United States
CDC: recommended adult immunization schedule for ages 19 years or older, United States
Meningitis Now: bacterial meningitis
CDC: meningitis

Referenced Articles

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